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Bacterial infections III - atypicals Flashcards

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1
Q

3 atypical causes of pneumonia

A
  1. mycoplasma
  2. legionella
  3. chlamydia
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2
Q

mycoplasma are small bacteria lacking ____

A

a cell wall

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3
Q

mycoplasma are commonly found where?

A

lining mucous membrane of:
1. rsp tract (especially)
2. genitourinary tract

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4
Q

___ is most associated with acute pneumonia

A

M. pneumoniae

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5
Q

mycoplasma causes ___ (2)

A

epithelial injury
activates immune response

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6
Q

what causes the milder form of “pneumonia” and is often associated with bullous myringitis and referred to as “walking pneumonia”

A

M. pneumoniae

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7
Q

presentations of M. pneumoniae

A
  1. clear auscultation
  2. no lobar consolidated
  3. diagnosed by NP swab**
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8
Q

clinical suspicion of M. pneumoniae in CAP what should be initiated?

A

empiric tx
azithromycin (z pack)

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9
Q

what is an obligate intracellular bacteria that does not contain a peptidoglycan cell wall

A

chlamydia

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10
Q

what is the second most common cause of “atypical” pneumonia

A

chlamydia pneumoniae

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11
Q

what causes an “atypical” pneumonia with fever, chills, cough, HA and comes from contact with birds?

A

chlamydia psittaci

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12
Q

tx to chlamydia psittaci

A

tetracycline
erythromycin

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13
Q

what is the most common STD

A

chlamydia trachomatis

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14
Q

clinical manifestations of chlamydia

A

female:
- cervicitis
- urethritis
- PID
male:
- urethritis
- epididymitis
- prostatitis
BOTH:
- conjunctivitis
- lymphogranuloma venereum*

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15
Q

typical presentation of chlamydia

A

pain, tenderness, inflamed
mucopurulent/mucoid/watery discharge

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16
Q

is gram stain helpful for chlamydia trachomatis?

A

no! they have no cell wall

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17
Q

screening for chlamydia is recommended for:

A
  1. pregnancy
  2. sexually active females +25 y/o
  3. positive risk factors
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18
Q

DDX of cervicitis

A
  1. chlamydia
  2. gonorrhea
  3. trichomoniasis
  4. BV
  5. candidiasis
  6. HSV
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19
Q

tx for urogenital chlamydia

A

azithromycin PLUS ceftriaxone (for gonorrhea)

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20
Q

complications with chlamydia trachomatis

A
  1. periphepatitis (fitz Hugh-curtis syndrome)
  2. pregnancy complications - PROM (premature rupture of membranes)
  3. infertility (from PID)
  4. transmission to newborn
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21
Q

3 spirochetes

Study These Flashcards
A
  1. treponema pallidum - syphilis
  2. borrelia - lyme disease
  3. leptospira - leptospirosis
22
Q

clinical stages of syphilis

Study These Flashcards
A
  1. primary
  2. secondary
  3. tertiary/late
  4. neurosyphilis
  5. latent
23
Q

clinical manifestations of primary syphilis

Study These Flashcards
A

appears 2-4 wks after contact
chancre* - painless ulcer
spontaneous healing

24
Q

steps into diagnosing primary syphilis

Study These Flashcards
A
  1. culture ulcer via dark field microscopy
  2. non-treponemal antibody test
  3. treponemal antibody tests - after #2 is positive
25
tx for primary syphilis
benzathine PCN G single dose
26
when is syphilis considered secondary
begins several weeks to 6 months after chancre - disseminates of T. pallidum through body (systemic infection!) *still infectious
27
work-up and tx for secondary syphilis is the same as ____
primary syphilis
28
2 types of latent syphilis
1. early - within 1st year after primary infection - STILL INFECTIOUS 2. late - after 1st year of latent infection - NONINFECTIOUS
29
how does tertiary/late syphilis occur?
occurs any time after UNTREATED secondary syphilis (rare)
30
presence of gummas is indicative of ?
tertiary/late syphilis infiltrative tumors that can go to the skin, bones, internal organs
31
neurosyphilis is most common in what stage?
late syphilis can still occur in any stage of disease
32
disease course of neurosyphilis
1. asx 2. meningovascular syphilis - meningeal symptoms 3. tabes dorsalis - progressive degeneration of posterior columns of spinal cord 4. general paresis - involvement of cerebral cortex - personality change - memory loss - psychosis - slurred speech - dysarthria - tremors
33
diagnosis/tx for neurosyphilis
1. LP (diagnose) 2. PCN
34
risk factors of neurosyphilis
1. HIV 2. Non-HIV - males - +45 y/o
35
what is the most common mode of transmission of borrelia burgdorferi
ticks
36
stage 1 of lyme disease
1. erythema migrans* - flat "bulls' eye" lesion with central clearing - occurs 1 wk after tick bite 2. flu-like (resolves 3-4 wks w/o tx)
37
stage 2 of lyme disease
early disseminated infection 1. bacteremia 2. secondary lesions and rash 3. worsening flu symptoms 4. cardiac involvement - arrhythmias and HB (4-10% of pts) 5. neurologic manifestations - aseptic meningitis, facial palsy (10-15% of pts)
38
stage 3 of late persistent infection of syphilis
1. MSK (60%) 2. neurologic 3. skin
39
criteria for lyme disease diagnosis
exposure to tick bite who: - developed erythema migrans or - at least one late manifestation AND - lab confirmation
40
to have lab confirmation of lyme disease, you order
ELISA - detects antibodies to B. burgdorferi Western Blot
41
tx for lyme disease
doxy for 2-4 wks
42
leptospirosis is transmitted by ?
ingestion of food/drink contaminated by urine of infected animal (rat)
43
tx for leptospirosis
doxycycline
44
rocky mountain spotted fever is transmitted via
ticks! tick bourne illness
45
what is the most serious rickettsia disease
rocky mountain spotted fever
46
presentation of rocky mountain spotted fever
Rash* - faint macules progressing to papules, then to petechiae - appears first on wrists and ankles and spreads from distal to proximal
47
what is the tx for rocky mountain spotted fever
doxy! within 5 days NO AMOXICILLIN
48
what is the rickettsia disease that is commonly seen with tick vectors in tropical settings
typhus
49
what is the rickettsia disease that is commonly seen with tick vectors in southern US
ehrlichiosis
50
what is the rickettsia disease that is commonly seen with flea and body lice vectors throughout the US
anaplasma
51
what is the general tx for rickettsia diseases?
doxy

Infectious disease (15 decks)

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